Endobronchial Ultrasound Staging of Operable NSCLC: Do Triple Normal Lymph Nodes Require Routine Biopsy?

Endobronchial Ultrasound Staging of Operable NSCLC: Do Triple Normal Lymph Nodes Require Routine Biopsy? Chest. 2021 Jan 09;: Authors: Hylton DA, Kidane B, Spicer J, Turner S, Churchill I, Sullivan K, Finley CJ, Shargall Y, Agzarian J, Seely AJE, Yasufuku K, Hanna WC, Canadian Association of Thoracic Surgery Research Group Abstract BACKGROUND: Staging guidelines for lung cancer recommend endobronchial ultrasound (EBUS) and systematic biopsy of at least 3 mediastinal lymph node (LN) stations for accurate staging. A 4-point ultrasonographic score (Canada Lymph Node Score- CLNS) was developed to determine the probability of malignancy in each LN. A LN with a CLNS<2 is considered low probability for malignancy. We hypothesized that, in patients with cN0 non-small cell lung cancer, LNs with CLNS<2 may not require routine biopsy because they represent true node negative disease. RESEARCH QUESTION: Do lymph nodes considered triple normal on CT, PET, and CLNS require routine biopsy? STUDY DESIGN AND METHODS: LNs were evaluated for ultrasonographic features at the time of EBUS and the CLNS was applied. "Triple Normal" LNs were defined as cN0 on computed tomography (short axis <1cm), positron emission tomography (no hypermetabolic activity), and EBUS (CLNS<2). Specificity and negative predictive value (NPV) were calculated against the gold-standard pathological diagnosis from surgically excised specimens. RE...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research